Humans are all almost exactly the same... almost - Greg Foot

翻译人员: Layla March 校对人员: Jacky He

Medical science has a problem— it’s missing something.

医学有个问题—— 它缺少了一些东西。

Something that means that not only is it harder to find

这不仅意味着难以找到

the causes of some diseases—

某些疾病的成因，

and effective ways to treat them—

或者治疗它们的有效方法，

some diseases are getting overlooked entirely.

而且有些疾病被完全忽略。

It turns out what it’s missing could be you—

似乎缺少的是你，

but I’ll get to that in a bit.

但这我待会解释。

Because first, a story.

因为首先，我要讲一个故事。

Or 8 billion stories, to be precise.

或者准确地说，是八十亿个故事。

See, our DNA is our body's instruction manual, sure.

我们的 DNA 算是我们身体的 使用说明书。

But it’s also a history book that records our own, unique genetic story.

但它也是一本记录我们 独特基因故事的历史书。

All our stories begin around 300,000 years ago

我们所有的故事 从三十万年前开始，

when humans arose in Africa.

那时，人类出现在了非洲。

Some genetic stories tell of leaving a couple of hundred thousand years later,

有些遗传的故事发生在 几十万年以后，

journeying into Europe, East Asia, or the Americas.

进入了欧洲、东亚或美洲。

Some genetic stories speak of expanding empires.

有些遗传的故事关于扩张的帝国。

Others the diseases we evolved to ward off,

另一些关于我们 演化出免疫力的疾病，

and some the simple act of settling down, raising cattle, and drinking their milk.

还有一些涉及简单的行为 像定居，畜牧，和喝奶。

Each of our genetic stories are different,

我们每个人的基因故事各异，

but maybe not as different as you might expect.

但也许没你想的那么不同。

We share 99.9% of our DNA with each other.

我们彼此共享 99.9% 的 DNA。

Our stories are 99.9% identical,

我们的故事 99.9% 相同，

but that 0.1% difference is incredibly powerful.

但那 0.1% 的差异 非常强大。

In that tiny difference between our genetic stories

我们的遗传故事中 那细小的差异，

is where we have the potential to develop better treatments for diseases—

使得我们能够研发出 更好的疾病治疗方案。

treatments that work for everyone.

使每个人受用。

But medical science isn’t currently reading all those stories.

但医学目前还没有 细读所有这些故事。

To explain let me tell you how researchers work out the causes of diseases,

为了解释，让我告诉你研究人员 是如何找出疾病的成因，

and develop and test the effectiveness and safety of new treatments.

开发和测试新疗法的 有效性和安全性。

To find out the causes of a particular disease,

以找出一类疾病的成因，

researchers find lots of people who have that condition

研究人员找到很多有这种疾病的人

and comb through their genetic stories.

并研究它们的遗传故事。

They look for little variations they share—

他们记录这其中的差异

little bits of their DNA stories that are spelt differently.

看他们的 DNA 故事在哪里不同。

If they find some, then they try all sorts of different ways

如果发现差异，那么他们会 尝试各种不同的方式

of dealing with the effect of them.

对付这些的影响。

And if that uncovers something that looks promising,

如果发现一个看起来 具有潜力的解决方案，

they then run a clinical trial to see if it actually is.

他们会进行临床试验以进一步研究。

In phase one, a small group of volunteers try the treatment.

首先，一小群志愿者接受治疗。

Well, often only half of them do,

实际上，只有一半的人接受治疗。

with the other half getting a placebo that does absolutely nothing.

另一半服用安慰剂，毫无作用。

If there aren’t any notable side effects at the target dose,

如果在目标剂量下 没有明显的副作用，

the treatment is cleared to move on to the next stage of the clinical trial.

治疗将获准进入 下一阶段的临床试验。

Phase two, this time with a bigger group of participants

第二步，更多的志愿者参与，

who all have the condition the researchers hope the drug will treat.

且患有研究人员希望治疗的病症。

If the drug appears effective, it moves on to phase three,

如果药物看起来有效， 它进入第三步，

with more participants trying it for even longer.

包含更多参与者和更长时间的试验。

Only after all this is the new treatment then reviewed

只有在此过程之后，新疗法才被审查，

and— hopefully— approved for use by us, the general population.

并幸运的话被批准广泛使用。

But there's a problem with it.

但存在一个问题。

Here is the ethnicity of lots and lots of people used to recently find

这是最近用于研究疾病 成因的人的种族。

the causes of various diseases.

[欧洲人、亚洲人、非洲人、拉丁裔]

And here is how that compares to the ethnic diversity

这是跟世界多样的人口

of the world’s population.

现状相比较。

Spot the difference?

你能看到区别么？

The genetic stories that researchers are combing through are heavily biased

研究人员关注的遗传故事主要

to those of people from European descent.

是欧洲血统。

Which means that if you’re searching

这意味着，如果你正在

for those disease-causing bits of DNA to target new drugs against,

寻找那些致病的 DNA 片段用于新药，

and you're mainly reading the stories of people of European descent,

而你主要是在研究欧洲人的基因故事，

you might completely overlook key bits in the stories

你可能完全忽略 其他不同族裔故事里的

of other diverse groups that tell of, say,

关键部分，可能涉及

a changed risk of disease or even shed light on how a disease occurs—

患病风险的改变， 甚至疾病产生的机制。

for example, scientists may not have found the mutation

例如，如果科学家只研究欧洲血统，

that causes sickle cell disorder

他们就可能不会

if we’d only looked in the stories of people of European descent.

发现导致镰状细胞病的突变。

And the thing is, what medical science is missing doesn't end there.

事实是，医学科学的缺陷不止于此。

When new treatments or medical devices are being tested,

当新的治疗方式、 设备经受测试时，

they need to be tested on everyone that may use them.

他们需要对每位可能的患者进行测试。

If the genetic stories involved don’t reflect the breadth of stories

如果考虑的遗传故事不足以反映

in our worldwide library then, again, something might be missed.

我们全球范围的基因集的丰富度， 便可能漏掉些东西。

Take, for example, the medicine Warfarin; used to prevent blood clots.

例如: 用来防止血栓的药物 华法林 (Warfarin)。

Researchers have found that, to produce the same effect,

研究人员发现， 以产生相同的效果，

most people of East Asian descent need a lower dose

大多数东亚族裔人需要

than some people of European descent,

比某些欧洲人更低的剂量，

and most people of African ethnicity need a larger dose.

而大多数非洲人 需要更大的剂量。

Which means the dose that works best for someone

这意味着任何人的最佳剂量

may vary according to their ethnicity.

可能取决于他们的族裔。

It’s this kind of important information that can be missed if clinical trials

如果临床试验不包括多个族裔

don’t include people from across a range of ethnicities.

这样的重要信息便会遭遗漏。

So what’s the solution?

那么解决方案是什么？

Well, it’s quite simple... in theory.

其实, 这挺简单的...理论上讲。

In order to develop treatments that work better for everyone,

为了使得治疗对每个人都有效，

we need to involve everyone’s stories in medical research—

我们需要把所有人的故事 包括在医学研究中，

in the early stage research, in the drug development process,

在早期研究中， 在药物研发过程中，

and right through the clinical trial.

和在临床试验中。

The good news is that more and more people are thinking about this.

好消息是越来越多 人们正在思考这个问题。

For example, cancer researchers at University College London

比如，伦敦大学学院的 癌症研究人员，

researching genetic markers for cancer want to analyze tissue samples

正在研究来自多个族裔的

from a wide range of ethnicities so that the biomarkers of cancer they identify

组织样本中的基因标记； 这样它们找到的癌症生物标志

will be relevant for people from as many ethnicities as possible.

将对尽可能多的族裔适用。

Bottom line: medical science needs to ensure

结论是，医学需要确保

it’s got the best library it can have—

它拥有最全的图书馆，

the one with the widest collection of genetic stories possible,

拥有最繁多的遗传故事,

so that everyone’s story can be considered—

使每个人的故事被考虑，

including yours.

包括你的。

That is the only way to ensure everyone, everywhere

只有这样才能保证 任何人在任何地方

can get the best medical treatment they possibly can.

都能得到最佳的医疗。